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Extended Preventive Counseling Visit

New York rates for HCPCS 99403

A clinician spends a substantial one-on-one session, roughly 45 minutes, counseling a patient on ways to reduce personal health risks, for example around diet, exercise, or other lifestyle factors, separate from a routine checkup. It is handled as its own visit rather than folded into another type of appointment. This length of session allows more in-depth discussion than a brief counseling conversation.

Rates data updated July 2026.

Facilitymedian $83 · 10th–90th $65$1350%20%10th90th$83Professionalmedian $89 · 10th–90th $65$1740%20%10th90th$89$0.1$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$83.18
Typical High
$138.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$77.62
Typical High
$123.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$85.11
Typical High
$91.20
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$83.18
Typical High
$114.82
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$125.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$109.65
Typical High
$208.93
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$0.10
Median
$0.10
Typical High
$100.00
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$95.50
Typical High
$169.82
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$81.28
Typical High
$102.33
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$102.33
Typical High
$190.55
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$117.49
Typical High
$138.04
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$123.03
Typical High
$213.80
United
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$95.50
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$128.82
Typical High
$363.08
Univera
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$74.13
Typical High
$162.18
Univera
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$100.00
Typical High
$177.83